Provider Demographics
NPI:1083132492
Name:GREATER BALTIMORE HOMECARE LLC
Entity Type:Organization
Organization Name:GREATER BALTIMORE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPRETI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-497-4215
Mailing Address - Street 1:8629 DELEGGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2136
Mailing Address - Country:US
Mailing Address - Phone:410-497-4215
Mailing Address - Fax:
Practice Address - Street 1:407 S CONKLING ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2404
Practice Address - Country:US
Practice Address - Phone:410-497-4215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care